Individual
MRS. VANESSA M RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
205 E 86TH CT, MERRILLVILLE, IN 46410-6259
(219) 769-9070
(219) 769-1758
Mailing address
205 E 86TH CT, MERRILLVILLE, IN 46410-6259
(219) 769-9070
(219) 769-1758
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001486A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100212430
—
IN
Enumeration date
08/13/2008
Last updated
11/04/2014
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